Creating a Birth Plan - Part One: Labor

Once Cozy Baby #2 became a reality, I was determined to develop a plan for my labor and delivery.  This has been such an important element of my pregnancy that I wanted to share the information with all of you!  With my first child, I had nothing planned - Zero.  This resulted in a stressful birth where I had no clue what was going on and how to answer even the most basic of questions.  I had known that a lot women had "birth plans," but I didn't even know where to start on creating one - I hope that this can help anyone going through a similar situation.

So WHY am I even bothering with this after successfully navigating an unmedicated birth last time without one - Surely I'm better prepared and know what to expect, right?  I don't think so.  First of all, I gave birth to my son six years ago - that's a long time and I've changed a lot since then.  Second, while I was overjoyed at having my son, labor and delivery wasn't a happy experience for me.  Third, I want to make the most of what will likely be my last time giving birth.

Also, just to clarify, this isn't a series that will push "natural birth versus medicated birth" - I support all birth options, even if you choose to go a different route than me.  What's important about giving birth is that YOU are comfortable with what's happening... and that changes from woman to woman.

So let's get started!

• Who?  This is an easy question for me, but might be a hard one for those with large families, or family members planning to fly in from out of town for the delivery - Are those family members expecting to be in the delivery room with you?  Do you WANT them in the delivery room with you?  Do you have older children that you want in the delivery room?  My hospital doesn't allow siblings under the age of 12 - Do you know the policies of your hospital or birthing center?
• Induction: What happens if your labor stalls, or if your labor just DOESN'T start at all?  Have  a plan in place for induction - Do you want to try natural approaches to inducing labor, or are you comfortable starting with medications like Pitocin?  Are you even aware of the natural methods available to you?  Do your research on things like homeopathic/herbal interventions, nipple stimulation, and even acupuncture.
• Hydration: IV's are typical in hospital labors - But what if you'd feel more comfortable eating and drinking during labor?  Talk with you healthcare provider about how they handle hydration during labor so that you know what to expect - and so that you can request alternatives if you aren't satisfied with their normal procedures.
• Contractions and Birth Aids: Have you taken birthing classes that taught you a specific method to "ride through" your contractions?  Do have a preferred approach to handling the pain of contractions - like breathing methods, a birthing ball (my personal favorite), a stool, specific positioning, etc?   Be sure you know how you want to approach your contractions so that the people around you can support you as you work through your labor.
• Monitoring the Baby: I mention this one because it was the MOST frustrating part of my labor experience with my son.  Do you know how your healthcare provider is planning to monitor your baby's heart rate and how often?  Are you comfortable with continuous external monitoring?  What about a scalp monitor?
• Medication: This is the BIG one.  Most conversations about the labor experience start with "medication or no medication?"  Definitely have this planned out - I didn't with my first and it was really confusing to feel pressure from healthcare staff and family to do one or the other without really knowing what I wanted.  Talk to your healthcare provider about the different medication options for pain, how they may impact the progression of your labor, will the medications effect your baby, and what (if any) is the recovery time associated with each option.  Epidurals aren't the only options out there, so educate yourself!
• Episiotomies and Tearing: This was another reality from my first labor - Have you thought about whether you would like to try alternatives like perineal massage before resorting to an episiotomy?  Would you rather tear naturally than have the incision?  Talk to your healthcare provider about their approach to tearing as well so that you're prepared for their advice during labor.
• The Unspeakables: Labor can come with some really unappealing experiences - like urinary catheters, enemas, etc.  Yuck, but sometimes a labor reality, depending on your healthcare provider.  Would you prefer to set the ground rules from the beginning that you don't want either?  Do you not care?  Do you even know when they might be needed?
• Atmosphere: Is the environment in the delivery room really important to you?  Maybe your birthing center has specific options available for lighting, music, and aromatherapy?  If you're giving birth at home, do you know how you want the room set-up?  If you're giving birth in the hospital, what options are available to limit noise? 
• C-Sections: Some women know going into labor that they are having a c-section - you've been advised against a VBAC, your child is deemed too large for vaginal delivery, health concerns, etc.  If you are one of those women, have a very long and detailed conversation with your healthcare provider on what to expect - Length of the procedure, what happens to the baby afterward, what the recovery time is like, etc.  Be educated - this is a major surgery and there is a lot that comes with it, despite the current culture that c-sections are "normal."

This is only the first post in my "Birth Plan Series" - this series will also cover Delivery, Postpartum, Emergencies, and Composing your Birth Plan.  This isn't, of course, going to include every possible consideration - but it'll hit the bigger topics and touch on alternative interventions.